The objective of this guideline is to aid clinicians in making individual salvage treatment plans for pediatric and adolescent patients with first relapse or refractory (R/R) classical Hodgkin lymphoma (cHL). While salvage with standard dose chemotherapy followed by high dose chemotherapy and autologous stem cell transplant is often considered the standard of care in adult practice, pediatric practice adopts a more individualized risk stratified and response adapted approach to salvage treatment with greater use of non-transplant salvage. Here, we present on behalf of the EuroNet Pediatric Hodgkin Lymphoma group, evidence and consensus-based guidelines for standardized diagnostic, prognostic and response procedures to allocate children and adolescents with R/R cHL to stratified salvage treatments.

AYA and Pediatric Radiotherapy Unit Centro di Riferimento Oncologico Aviano Italy

Children and Young People's Cancer Services University College Hospital London London UK

Department of Nuclear Medicine University of Leipzig Leipzig Germany

Department of Pediatric Hematology and Oncology University Hospital Motol Czech Republic

Department of Pediatric Oncology and Hematology Institute of Pediatrics Jagiellonian University Medical College Krakow Poland

Department of Pediatrics Royal Hospital for Sick Children Edinburgh Scotland UK

Department of Radiation Oncology Medical University of Vienna Vienna

Institute of Medical Informatics Statistics and Epidemiology University of Leipzig Leipzig Germany

Pädiatrische Hämatologie und Onkologie Zentrum für Kinderheilkunde der Justus Liebig Universität Gießen Gießen Germany

Prinses Máxima Centrum voor Kinderoncologie Utrecht The Netherlands

Section of Pediatrics Azienda Ospedaliero Universitaria di Ferrara Ferrara Italy

Service d'Hématologie et d'Oncologie Pédiatrique Hôpital Armand Trousseau Paris

Unit of Pediatric Onco Hematology Hospital Universitario Virgen Macarena Seville Spain

University Hospital Schleswig Holstein Department of Pediatric and Adolescent Medicine Pediatric Hematology Oncology and Stem Cell Transplantation Kiel Germany

University of Edinburgh and Department of Pediatrics Royal Hospital for Sick Children Edinburgh Scotland UK

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Transplant and Nontransplant Salvage Therapy in Pediatric Relapsed or Refractory Hodgkin Lymphoma: The EuroNet-PHL-R1 Phase 3 Nonrandomized Clinical Trial